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The nations of the Caribbean have the world’s second highest HIV infection rates, after sub-Saharan Africa. One Caribbean nation, Cuba, however, has largely escaped the disease with only a 0.07 percent infection rate, one of the lowest infection rates in the world. On July 15 Cuba announced at a meeting with its counterparts from the 15-nation Caribbean Community (Caricom) that it was launching an initiative to help the other Caribbean nations fight HIV/AIDS by providing them with antiretroviral drugs at below market prices, as well as doctors and instruction in public health methods for combating the AIDS pandemic. Cuba’s offer to help is viewed as nothing less than “spectacular” by the other Caribbean nations.

Why has Cuba managed largely to escape the AIDS pandemic? And why is Cuba in a position to offer so much aid to the other Caribbean nations—aid that is not forthcoming from much richer countries such as the United States? In 1983 Fidel Castro spoke to the Institute of Tropical Medicine in Cuba declaring that the mysterious illness, later known as AIDS, would be “the disease of the century.” Cuba moved quickly to ban the import of blood from other countries and to test Cuban blood donations. Cuba also instituted mandatory HIV testing of at-risk communities such as soldiers returning home from abroad, tracing the history of sexual contacts of infected persons, and beginning in 1986 committing all those who tested positive for HIV to sanatoriums. The policy of quarantining those who were HIV positive came under heavy criticism from numerous global human rights groups, who saw it as a human rights violation. Cuba had rightly come under criticism for disgraceful anti-gay police measures taken in the late ’60s and early ’70s and then later repudiated. There were fears that all of this would be repeated in the context of the AIDS crisis (though the earliest AIDS patients in Cuba were heterosexuals who had worked abroad). Nevertheless, Cuba’s AIDS sanatoriums were praised for their conditions and the health provisions made for those living there. In the early 1990s Cuba allowed some of the patients in the sanatoriums to return home, and in 1994 it ended mandatory long-term confinement of those who were HIV positive. Building on its powerful public health model Cuba focused on AIDS education. Currently most patients spend a minimum of three months learning how to live with their illness, how to manage their medicines, and how to avoid spreading HIV to others.

Faced with the embargo from the United States that limited access to medicines and medical equipment, Cuban scientists beginning in 1993 placed heavy emphasis on developing antiretroviral drugs that could combat HIV. By 2001 Cuban medical research had on its own devised five different varieties of antiretroviral drugs. Every Cuban who is HIV positive has been put on therapeutic regimes utilizing these drugs. Cuba is now offering these antiretroviral drugs to all other Caribbean nations at affordable prices. Thus far poor nations have not been able to obtain the drugs they needed because of the high prices of such drugs emanating from pharmaceutical corporations in the United States and other capitalist countries. Cuba’s response to the AIDS pandemic is thus a blow against imperialism as well as a contribution to global human health and worldwide humanitarian goals.

Recalling the sad history of the anti-gay police campaign of three decades ago, initial criticism of the harsh sequestration policy was certainly understandable. But today it is clear that the overall Cuban public health response to AIDS has worked. It strikingly conveys the difference between a capitalist and a socialist society: the highest priority for the latter is the people. Cuba’s willingness to help other poor countries combat the AIDS pandemic is an important example of international solidarity, not domination of other countries.

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